The New Optimum Nutrition Bible

by Patrick Holford

  Vitamin C

  Vitamin C is water soluble and therefore excess is readily excreted from the body. Government recommendations vary considerably from country to country A general consensus based on up-to-date research is that 100 mg a day represents a good basic intake; the optimal intake is probably between 1,000 and 3,000 mg a day.

  A number of studies have investigated the effects of vitamin C on specific diseases, using over 10,000 mg a day. The recommendation of these high levels has attracted controversy and allegations that vitamin C can cause kidney stone formation, interferes with B12 absorption, and causes a “rebound scurvy” when supplementation is stopped. All these allegations have been shown to be without substance. The only drawback to taking large amounts of vitamin C is that it can have a laxative effect. Generally, supplementing up to 5,000 mg of vitamin C a day can be considered safe.

  Vitamin B

  The B vitamins are water soluble and excess is readily excreted from the body in the urine, so they are generally of very low toxicity. Thiamin (B1), riboflavin (B2), pantothenic acid (B5), B12, and biotin show no sign of toxicity at levels of at least one hundred times the U.S. RDA. vitamin B3 in the form of niacin causes blushing at levels of 75 mg or more; this is part of its natural action and therefore is not generally considered to be a toxic effect.

  According to Dr. John Marks at Girton College, Cambridge, “doses of 200 mg to 10 g daily have been used therapeutically to lower blood cholesterol levels under medical control for periods of up to ten years or more, and though some reactions have occurred at these very high dosages, they have rapidly responded to cessation of therapy, and have often cleared even when therapy has been continued.” Levels of up to 2,000 mg per day on a continuous basis are considered safe.

  Vitamin B6 has been extensively tested for toxicity by a number of research groups including the U.S. Food and Drug Administration, which concluded that “in man, side effects were not encountered with daily administration of 50 to 200 mg over periods of months.” Most of the unfounded reports of low-dose B6 causing nerve damage appear to be based on one well-documented case of a woman who increased her B6 intake from supplements of 500 mg to 5,000 mg over a period of two years and developed muscle weakness and pain that were attributed to nerve damage.

  One researcher, investigating seven cases of people taking 2,000 to 5,000 mg of B6 a day for considerable lengths of time, said that “substantial improvement occurred in all cases in the months after withdrawal of pyridoxine, usually with improvement in gait and less discomfort in the extremities, but in some patients, residual neurological discomfort remained.” In rats, daily injected doses of 600 mg/kg, equivalent to 3,800 mg a day in a person weighing 140 pounds, caused peripheral neuropathy, with tingling and numbing of the hands and feet.

  Deficiency of vitamin B6 induces the same symptoms. The likely explanation is that, in order to become active in the body where it helps enzymes to work, pyridoxine must be converted to pyridoxal phosphate. If the body is saturated with excessive pyridoxine, this conversion does not take place: enzymes become saturated with simple pyridoxine and so do not work properly. So B6 excess may, in fact, induce what are effectively B6-deficiency symptoms. Since zinc is required for the conversion of pyridoxine to pyridoxal phosphate, taking B6 with zinc is likely to reduce its toxicity. In any event, a daily intake of up to 200 mg on a continuous basis is generally considered safe.

  The safety of minerals

  The safety of minerals depends on three factors: the amount, the form, and the balance with other minerals in the diet. First, all minerals show toxicity at exceedingly high doses. Where form is concerned, trivalent chromium, for example, is essential, while hexavalent chromium (found in neither foods nor supplements) is very toxic. And as for balance, iron supplementation can exacerbate zinc deficiency since it is a zinc antagonist. The reason for such antagonism is that the shape of the atoms of many minerals is very similar. They are really just different sizes of cogs, so if you lack one mineral but take in an excess of a similar-shaped one, it can slot into the wrong enzyme, speeding it up, slowing it down, or simply stopping it from working altogether.

  In view of these factors, the levels given in the following pages as safe for long-term consumption presuppose that other essential minerals are also adequately supplied. Larger amounts than those stated may also be safe for short-term use, particularly for people with certain illnesses that result in an extra requirement for a mineral. Selenium requirement, for example, is thought to increase in certain types of cancer.

  Calcium

  The best-absorbed of calcium’s many forms include calcium ascorbate, amino acid chelate, gluconate, orotate, and carbonate. In normal, healthy people, there is little danger of toxicity since the body excretes excessive amounts. In some cultures, people consume in excess of 2 g a day from their diet alone, so this amount is certainly considered safe. Calcium-deficiency disorders are treated with 3.6 g per day.

  Problems of excessive calcium arise from other factors, such as excessive vitamin D intake (above 25,000 IUs per day) or parathyroid or kidney disorders. Calcium interacts with magnesium and phosphorus, so calcium supplementation should be given only to people with adequate magnesium and phosphorus intake or supplementing these elements. Phosphorus is rarely deficient, while magnesium deficiency is quite common. The ideal calcium to phosphorus ratio is probably 1:1. Less than 1:2 is not desirable. The ideal calcium to magnesium ratio is probably 3:2.

  Magnesium

  The best-absorbed of magnesium’s many forms include magnesium aspartate, ascorbate, amino acid chelate, gluconate, orotate, and carbonate. Toxic effects include blushing of the skin, thirst, low blood pressure, loss of reflexes, and respiratory depression. Toxicity is likely to occur only in people with kidney disease who are taking magnesium supplements. For normal, healthy adults, a daily intake of up to 1,000 mg is considered safe. Magnesium interacts with calcium, so magnesium supplements should be given only to people with adequate calcium intake or supplementing calcium. The ideal ratio of magnesium to calcium is probably 2:3, and in cases of magnesium deficiency 1:1.

  Iron

  This is one of the most frequently deficient minerals. According to the Health & Nutrition Examination Survey, nine out of ten women were obtaining insufficient iron from their diet. Iron comes in many different forms, the best absorbed of which include ferrous aspartate, amino acid chelate, succinate, lactate, and gluconate (ferric forms are less well absorbed).

  Ferrous sulfate is less toxic than ferric forms of iron. Even so, 3 g of ferrous sulfate can cause death in an infant, compared with 12 g for an adult. Supplements containing a significant amount of iron should be kept in a childproof container. Iron is stored in the body and therefore toxicity can result from chronic excessive intake, producing hemosiderosis, a generalized deposition of iron within body tissue, or hemochromatosis, normally a hereditary condition resulting in cirrhosis of the liver, bronze pigmentation of the skin, diabetes, arthritis, and heart abnormalities.

  Hemochromatosis is far more common than is realized. One in two hundred people has these genetic mutations that mean they are at risk of suffering from iron overload, the symptoms of which are extreme fatigue and abdominal pain. Provided you don’t have hemochromatosis, 50 mg a day as a supplement is generally considered safe; however, even this is unnecessary to correct acute anemia. A third of pregnant women show some level of iron-deficiency anemia, which is easily corrected by supplementing up to 25 mg a day.

  Iron is antagonistic to many other trace minerals including zinc, which is often deficient, especially among pregnant and lactating women. Therefore, extra iron should not be supplemented without ensuring adequate zinc status or supplementing zinc. The normal requirement for zinc and iron is approximately equal.

  Zinc

  This is one of the most thoroughly researched and commonly deficient minerals. About a thousand papers are published each year indicating its value for a variety of conditions. The best-absorbed
forms of zinc include zinc picolinate, amino acid chelate, citrate, and gluconate. Zinc supplementation is relatively nontoxic. When it’s taken in doses of 2,000 mg, symptoms of nausea, vomiting, fever, and severe anemia have been reported. Small amounts of zinc, particularly in the form of zinc sulfate, can act as an irritant in the digestive tract when taken on an empty stomach. There is also some evidence that, at levels of 300 mg per day, zinc may impair rather than improve immune function. It is generally considered safe to supplement up to 50 mg per day.

  Zinc is an iron, manganese, and copper antagonist; therefore, an adequate intake of these minerals is advisable if large amounts of zinc are taken over a long period. Manganese is very poorly absorbed, so it is generally advisable to supplement half as much manganese as zinc if more than 20 mg of zinc a day is supplemented. The normal requirement for zinc is about ten times that of copper. Since the average intake of copper for people on a healthy diet is on the order of 2 mg, those supplementing more than 20 mg of zinc may be advised to add 1 mg of copper for each additional 10 mg of zinc. It is also best to ensure that at least 12 mg of iron is supplemented when you are taking more than 20 mg of zinc.

  Copper

  Deficiency of this mineral is quite rare, probably because we get it from drinking water as well as from unrefined foods. The best-absorbed forms of copper include copper amino acid chelate and gluconate. Requirements are low (2 mg per day), and only 5 mg a day is required to correct deficiency. Toxicity does occur, mainly due to excessive intake from water that flows through copper pipes. Copper is also a strong antagonist of zinc, and for this reason it is advisable not to supplement more than 2 mg or a tenth of one’s intake of zinc. Copper also depletes manganese.

  Manganese

  No more than 2 to 5 percent of dietary manganese is absorbed, so increasing your intake from food has only a slight effect on overall body levels. The better forms for absorption include amino acid chelates, gluconates, and orotates. There is some evidence that vitamin C may help the absorption of manganese. In animals, it is one of the least toxic of all trace elements. Toxicity has never been reported in humans. A daily intake of up to 50 mg is considered safe. Excessive zinc or copper intake interferes with manganese uptake.

  Selenium

  This trace element is required in very small amounts of 25 to 200 mcg per day. It comes in two forms: organic, such as selenomethionine or selenocystine, sometimes in the form of selenium yeast; and inorganic, as sodium selenite. The inorganic form is more toxic, with toxicity occurring at levels of 1,000 mcg or more. The organic forms show toxicity above 2,000 mcg. No toxicity has been reported with either form at intakes of 750 mcg. An intake of up to 500 mcg for an adult is generally considered safe. In view of the relatively small difference between beneficial and detrimental intake, selenium should be kept out of reach of children.

  Chromium

  Of the two forms of chromium found in nature, hexavalent and trivalent, hexavalent is much more toxic. However, it is found neither in food nor in supplements, so contamination can occur only from occupational exposure. The better-absorbed forms of chromium are picolinate, amino acid chelate, and polynicotinate. Trivalent chromium has a very low toxicity, partly because so little is absorbed. An intake of up to 500 mcg is certainly considered safe.

  You might have heard a rumor that chromium picolinate could cause DNA damage. This was based on a study in 1995 in which hamsters were given amounts of chromium several thousands of times higher than you would ever take in a supplement.6 A further animal study in 1997 gave amounts five thousand times higher than the 200 mcg I recommend and failed to find any evidence of toxicity.7 Since then a decade of research including more than thirty human trials has also shown no safety concerns. The fact is, there is no evidence that supplementing chromium picolinate, let alone any other form of chromium, has the potential to cause cancer in either animals or humans. In the United States, the National Toxicology Program investigated chromium picolinate and found no evidence of “genotoxicity” or any other ill effects. And now, even the UK’s Food Standards Agency agrees that chromium is nontoxic, even in amounts ten times higher than the average 200 mcg supplement.

  PART 7 A to Z of Nutritional Healing

  A to Z of Nutritional Healing

  While there is no substitute for individual assessment of nutrient needs, the following nutritional advice is helpful for people suffering from particular health problems. For the more serious conditions, it is best to follow these programs under the supervision of your doctor or nutrition consultant. The supplements recommended are for adults and are based on the formulas given in chapter 47. Since dosage is crucial, it is best to get supplements close to these formulas. When individual amounts of a nutrient are given, these are the total required. Check that you are not “doubling up” by receiving, for example, vitamin A in a multivitamin, an antioxidant, and a separate supplement.

  For further guidance on supplement doses, stay within the ranges given in chapter 45, using the higher amounts for conditions that are specifically helped by these nutrients, or when symptoms of deficiency are present.

  All the recommendations given here are for adults. For guidance on supplemental levels for children, see chapter 40. For babies and infants, I recommend you read my book Optimum Nutrition Before, During and After Pregnancy.

  The recommendations given are aimed at helping to restore health in these conditions. They do not replace medical advice, nor should they be continued on an ongoing basis once the condition is corrected.

  The basics for any supplement program, given on this page, are 2 × a high-strength multivitamin and mineral (you can’t get optimum levels in only one pill), 1 gram or more of vitamin C, and an essential omega-3 and omega-6 supplement. You can get daily packs of these “basics,” which is a good place to start, adding any extras. The supplement directory in the Resources section gives some “best fit” products that meet the recommendations given below.

  Acne

  This condition is most prevalent among teenagers, and the hormonal changes that take place at this age are certainly at the root of many skin problems. These changes cause the sebaceous glands to produce too much sebum and keratin, which block up the skin pores making them more likely to get infected. A diet high in saturated fat or fried food also makes pores more likely to get blocked. Vitamin A deficiency produces skin congestion through excessive keratinization of skin cells. Vitamin A and zinc deficiency leads to lowered ability to fight infection, as does lack of beneficial bacteria (through overuse of antibiotics). Optimum nutrition helps by balancing hormones as well as reducing the risk of infection. The most important nutrients are vitamins A, B complex (especially B6), C, and E, zinc, niacin for skin flushing, and vitamin E for wound healing. Good diet and cleanliness are essential. Be careful of supplements with added iodine, which can make acne worse.

  Diet advice

  Follow an optimum diet and drink plenty of water. Sulfur-rich foods such as eggs, onions, and garlic are also helpful. Avoid sugar, cigarettes, and fried and high-fat foods. Eat plenty of fresh fruit and vegetables (high-water-content foods).

  Supplements

  2 × multivitamin and multimineral

  2 × antioxidant complex

  2 × vitamin C 1,000 mg

  Niacin (B3) 100 mg for thirty days (for flushing and cleansing the skin)

  Zinc 15 mg

  Vitamin E 600 IU (helps heal the skin)

  Use topical vitamin A cream (see Resources). Also read chapter 27.

  Alcoholism

  Particularly prevalent among histadelic (high-histamine) people (see this page), alcoholism may in part be a way of coping with the excess energy that such individuals produce. B vitamins, especially Bl, B2, B3, and B6, are destroyed by alcohol, which primarily affects the liver and nervous system. Vitamins A and C help protect the liver. Glutamine heals the gut and reduces cravings. A very alkaline diet reduces the craving for alcohol. Tyrosine and adaptogens help prevent emotional and physicals
lows after stopping. Emotional problems almost always underlie alcoholism, and these, as well as the addiction—which usually also exists for sugar—must be addressed.

  Diet advice

  Follow the recommended diet and eat plenty of whole grains, beans, and lentils. Drink plenty of water. Often, sugar addiction is substituted for dependency on alcohol, which is just another form of sugar, so sugar and stimulants are also best avoided. Eat frequent meals containing some protein foods such as nuts, seeds, fish, chicken, eggs, or milk products.

  Supplements

  3 × multivitamin and multimineral

  2 × antioxidant complex

  3 × vitamin C 1,000 mg

  Adaptogen herbs, plus tyrosine

  Bone mineral complex (providing 500 mg calcium and 300 mg magnesium)

  Glutamine powder 5 g twice a day in water on an empty stomach

  Also read chapters 35 and 38.